| Lifesmiles Dentistry | |
|
928 N Robinson Lifesmile Dentistry West Lafayette IN 47906-2766 | |
| (765) 743-3779 | |
| (765) 743-8767 |
| Full Name | Lifesmiles Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 928 N Robinson, West Lafayette, Indiana |
| Authorized Official Name and Position | Daniel W Krueger (OWNER PRESIDENT) |
| Authorized Official Contact | 7657433779 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifesmiles Dentistry 928 N Robinson West Lafayette IN 47906-2766 Ph: (765) 743-3779 | Lifesmiles Dentistry 928 N Robinson Lifesmile Dentistry West Lafayette IN 47906-2766 Ph: (765) 743-3779 |
| NPI Number | 1508931205 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 07/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508931205 | NPI | - | NPPES |
| 200270720B | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 12010165A (Indiana) | Secondary |
| 122300000X | Dentist | 12010165 (Indiana) | Primary |
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